Transforming healthcare with evidence-based practice
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The World Health Organization (WHO) defines evidence-based practice (EBP) as an interdisciplinary approach to clinical decision-making that includes the best available evidence, care context and preferences of health professionals.
Over time, EBP has evolved to integrate the best research evidence, clinical expertise, patients’ values and the context of the specific healthcare organisation. The rising adoption of EBP in healthcare is crucial to ensure patients receive high-quality care by minimising errors, enhancing safety, boosting care efficiency, and cutting costs. Access to evidence-based guidelines also provides reassurance to clinicians by allowing them to benchmark their practices against their peers.
Impact on the healthcare workforce
Evidence-based healthcare is an umbrella concept of EBP that includes nursing, midwifery, medicine, and allied health professionals. Its integration is essential for the healthcare workforce, as it allows them to build their knowledge, help standardise care and improve patient outcomes.
According to WHO, EBP increases job satisfaction, empowers the workforce, and helps promote professional development and lifelong learning by requiring those delivering care to keep up with the latest research and evidence in their field. Seamless integration of EBP into daily practice can improve the working environment, thereby improving outcomes for patients.
Divergence from EBP
While EBP is widely accepted as a gold standard for safe and effective person-centred care, divergences still occur to best adapt to individual patient needs. These include compassionate use of experimental treatments, personalised medicine, and shared decision-making in which patients and providers make decisions together even if they deviate from evidence-based guidelines.
Although EBP is a global phenomenon, its meaning can vary in different geographical regions according to factors such as healthcare systems, educational systems, research infrastructure, and professional norms.
Clinical decision support (CDS) tools, such as order sets and care plans, can integrate evidence-based content directly into the workflow. These tools aid with standardising care and providing health professionals with content to inform evidence-based decision-making. They also help compile clinical information in one place, maintain systems with the latest information, and provide guidelines in an accessible format.
One example is at Imperial College Healthcare NHS Trust, where Elsevier’s care planning solution was implemented across the nursing team. A total of 247 evidence-based, patient-centred care plans were integrated and made available to 4,000 nurses via the electronic patient record (EPR). The use of these care plans significantly reduced variation in patient care, boosting the nursing team's operational efficiency. Nurses reported that they valued the standardisation and structured coordination of the care plans.
“Embedding solutions to support the scope of practice of each discipline and the interprofessional team, enhances consistency in care and promotes best clinical practice,” said James Bird, chief nurse information officer at Imperial College Healthcare NHS Trust.
This case study shows how EBP can improve both workforce satisfaction and patient care when integrated into a healthcare setting.
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